Association between Tunneled Pleural Catheter Use and Infection in Patients Immunosuppressed from Antineoplastic Therapy. A Multicenter Study

Rationale: Patients with malignant or paramalignant pleural effusions (MPEs PMPEs) may have tunneled catheter (TPC) management withheld because of infection concerns from immunosuppression associated antineoplastic therapy.Objectives: To determine the rate infections related to TPC use and relationship therapy, immune system competency, overall survival (OS).Methods: We performed an international, multiinstitutional study patients MPEs PMPEs undergoing 2008 2016. were stratified by whether not they underwent therapy and/or immunocompromised. Cumulative incidence functions multivariable competing risk regression analyses identify independent predictors TPC-related infection. Kaplan-Meier method Cox proportional hazards modeling examine for effects on OS.Results: A total 1,408 TPCs placed in 1,318 patients. had a high frequency overlap between immunocompromised state (75–83%). No difference (6–7%), deep (3–5%), superficial (3–4%) rates subsets status was observed. The median time 41 (interquartile range, 19–87) days after insertion. Multivariable demonstrated that longer duration higher (subdistribution hazard ratio, 1.03; 95% confidence interval [CI], 1.00–1.06; P = 0.028). analysis showed better OS (hazard 0.84; CI, 0.73–0.97; 0.015).Conclusions: does appear be increased state. are low comparable those immunocompetent no relevant therapy. These results support palliation MPE regardless plans